NPI | 1417087529 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 1223X0400X Dentist, Orthodontics and Dentofacial Orthopedics (Licence: DE G1-0001334) |
Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: MD 13965) |
1223P0221X Dentist, Pediatric Dentistry (Licence: DE G1-0001334) | |
1223P0221X Dentist, Pediatric Dentistry (Licence: PA DS036119) | |
Enumeration Date | 2007-03-07 |
Last Update Date | 2021-08-31 |